Abstract：Objective：To observe the effect of Huoluo Gukang Pills on bone metabolism indexes and bone mineral density(BMD) in elderly patients with osteoporotic hip fractures after internal fixation. Methods：A total of 102 cases of elderly patients with osteoporotic hip fractures were randomly divided into the observation group and the control group，with 52 and 50 cases in each group respectively. Both groups were given routine treatment after the surgery， and the observation group was additionally treated with Huoluo Gukang Pills. The bone metabolism indexes and BMD were compared before and after treatment in the groups. Results：Before treatment，there was no significant difference being found in the comparison of bone alkaline phosphatase (BALP)， bone gla protein (BGP)， procollagen type I carboxy- terminal propeptide (PICP)，procollagen type I N-terminal propeptide (PINP)，tartrate-resistant acid phosphatase 5b (TRACP5b)， carboxy- terminal collagen crosslinks (S- CTX) in serum between the two groups (P＞0.05). After treatment，the levels of BALP，BGP，PICP，and PINP in serum in the two groups were increased (P＜0.05)， and the four levels in the observation group were higher than those in the control group (P＜ 0.05)；the levels of TRACP5b and S-CTX in serum in the two groups were decreased (P＜0.05)，and the two levels in the observation group were lower than those in the control group (P＜0.05). Before treatment， there was no significant difference being found in the comparison of the levels of BMD of thoracic and lumbar vertebrae between the two groups (P＞0.05). After treatment， the levels of BMD of thoracic and lumbar vertebrae in the two groups were increased (P＜0.05)，and the two levels in the observation group were higher than those in the control group (P＜0.05). There was no significant difference being found in the comparison of the incidence of adverse reactions between the two groups (P＞0.05). Conclusion： For elderly patients with osteoporotic hip fractures after internal fixation， Huoluo Gukang Pills can promote bone formation，reduce bone absorption，increase BMD，and has high safety.